Tag: cancer

I didn’t smoke, didn’t drink excessively, was reasonably healthy, but still managed to end up with a malignant lump on my kidney that was as heavy as your hand-luggage allowance. I’m fine – I was lucky to have a good surgeon and lucky the cancer hadn’t spread, and lucky that I’m having wonderful care in a first-world country with a marvellous health system.

But all of this plays into my thesis: luck is an incredibly important factor in life, and we tend to underestimate it. We especially underestimate good luck, or at least we ignore it and assume we deserve good things that happen to us: it’s down to some attribute of ours which others simply don’t have.

If you’re a generous spirit, you might say, “hey everyone, this wonderful thing happened to me, so it can happen to you”. But that’s disingenuous, and the same kind of lie the National Lottery uses each time it says “it could be you”. Yes, it could. There’s a 1 in 14 million chance, and you’re 5,000x more likely to be murdered by your wife. But it could be you.

But most people aren’t that generous or well-intentioned, and tend to start acting like twats as soon as they get a bit of cash. They are better human beings than you, and you’re all layabout scum who need to have their benefits scrapped and their children pushed up chimneys.

The sheer, enormous, gallumping good luck of being born in Chipping Norton to a stockbroker father who sent them to Eton doesn’t occur to the fortunate: they got there by the sweat of their smooth, egg-like brow.

But it’s not just the rich. Don’t get me wrong: I’m all for class-war, especially as the rich have been winning the class war for a generation, and it’s about time we fought back a bit, rather than voting against our interests because we’re idiotic enough to believe we have a chance of being let into the exclusive club at the top. But this isn’t a dig at the entitled, landed gentry. This is a dig at those who attribute their success to skill, rather than chance.

My brother is an example of misattributed good luck. We work in the same industry (web stuff) but he’s so rich he spends his evenings making paper-aeroplanes out of £50 notes, and throwing them into one of his many solid gold fireplaces. Whereas I earn the average salary, rarely get paid on time, and spend most evenings scraping burned cheese off a baking tray so I can have some sustenance to gnaw on as I warm my fingers around a guttering candle. It’s positively Dickensian round here.

Yes, he’s worked hard, but so have I, and so have you – but he’s managed to be lucky too, and that makes all the difference. He is, at best, moderately good at programming and fairly smart – although we shared the same teachers, and every one of them said I was the smart one, and my brother was the future accountant. I’m not boasting, I’m just trying to place my brother in context.

(But I am dead smart though.)

He wanted to work with computers, but he dropped out of university after 6 weeks, and took a job at the nearest place to home: he was lazy and didn’t want to travel. Luckily that company, which only employed 3 people at the time, grew over the coming years, and he remained senior because he was there early. He didn’t make it grow. He was just a functionary. It just grew under him.

So dumb luck ends up pushing him into being a director, because all of the first intake of staff were made directors. As a director-by-politeness he wasn’t really trusted to have responsibility, and didn’t have a department to run or any great strategic role. But it worked out OK for him anyway: he was on £75k, and when the company was bought out by a larger organisation he took home a cheque for an additional £128,000. And because he was a director of the small company, he remained a “director without portfolio” at the larger company, got a 50% pay increase and 7 weeks holiday per year.

That’s how it is for directors – no lack of money up at the top, folks!

After a few years of this he was head-hunted, because he was a director of a big company, so mustbe good, right? Well, not really – he’s kind of average, but the fact that he’s been lucky means he’s in a position that appears to demonstrate some kind of skill. It’s why Keira Knightley still gets acting jobs – she’s absolutely awful, but she was in that thing that made money in spite of her presence, just because she was lucky to be born to a casting director (there’s that luck again!). So people think she’s a safer bet than… well, practically anybody else. And as a result, she keeps being given roles that the hedge in my garden would be more convincing in.

It’s not skill. It’s luck. I just don’t have a lucky hedge.

So my brother was head-hunted, and is now a director (again), this time of a very large company. I won’t tell you their name, but they trade autos. Trading autos is what they do. They are, you could say, auto traders.

Does he have to work hard or be inventive or do anything to earn his position there? No. They don’t invent new things, they don’t employ a million people, they don’t help with Britain’s balance of trade. They’re what’s called an “agency business”, which takes a slice for putting customers in contact with suppliers. He doesn’t make cars, that’s done by a proper economy in Germany (where they don’t leave every damn thing to the market, they go out and try to make the market function for the good of all, so everyone is benefiting and feels they belong).

As a director of this massive business, my brother doesn’t even need to go out and find new customers, or even run a good website (just look at it – it’s gruesome). He is, entirely by chance, sitting at the top table in a business which dominates about 95% of car buying in this country.

But ask him, and he’ll tell you he earned all of that. He, alone, was able to achieve those things, and deserves £160k (plus bonus) for sitting in an office while you buy cars he doesn’t make and doesn’t even sell. It had nothing to do with just happening to live close to a company which needed a cheap junior programmer, it was just skill and dedication and a hidden, secret knowledge which the rest of us have no access to.

I like the guy. But he’s a real cunt.

Businesses rely on serendipity just as much as people do. When a company employs a guy, it takes a risk that he’ll be good at his job. Most are competent, some terrible, but occasionally you’ll get lucky: you’ll employ somebody who has connections, and they’ll land you more work. It’s not your skill, or his skill – it’s luck that he’s connected to the right people, and those people are also lucky (often by birth, race, sex or location) to have strings they can pull.

As a lucky company, which felicitously employed somebody who, by good fortune of birth, has those connections and can land new contracts, you will be able to make money. And sometimes you will make enough money to let you start crushing rivals. In time you’ll dominate to the extend that luck stops playing a part.

Luck is a throw of the dice, but if you dominate 95% of the market you own the dice and the table, and are guaranteed to win. That’s what globalisation has brought us: a dozen lucky fuckers who now own the casino, and appear to own governments too. Every party must be “business-friendly” as though being helpful and sympathetic to normal people is a sin, but being friendly to blank-eyed, environment-destroying, soulless money-making machines is a cardinal virtue.

And that’s why the neoConservative, Tory, Republican view of the world is bullshit: they want to be “business friendly”, and reduce taxes for those who are successful in the belief that it will encourage more success. But most success is dumb luck, and you can’t legislate for luck. So all they’re really doing is ensuring those who are born into that club (which, let’s face it, is most of the members) are well rewarded for being incredibly fortunate that they fell out of a wealthy womb.

Last year I found out I had cancer. Bummer! I got better, and other than a foot-long scar and an increased determination to be selfishly happy, I’m the same as I was before.

But it’s a pain in the arse to not have cancer any more. It’s not that I want sympathy – far from it, sympathy makes me feel very uncomfortable. But having had cancer once upon a time means that people look at me differently from now on. They assume I’m rotting away from the inside, or that there’s something about me which might be contagious, or that my body is somehow “wrong”. My body is wrong in lots of ways, as anybody who’s seen me naked can attest, but most of my wrongness is caused by Hobnobs.

In case you’re from overseas and don’t know what Hobnobs are, they’re an oaty biscuit with a delicious topping made from chocolate and crack cocaine. They’re also the gnarliest of the biscuits: you can dunk them in hot tea for hours at a time, and they retain their structural integrity. Only the Bourbon Cream is anywhere near as tough. For the benefit of Johnny Foreigner, the Bourbon Cream is a sandwich made up of two crunchy biscuits, bonded together with a layer of what might be cat sick.

Enough biscuit news, back to cancer. Yes, I’m missing a kidney, but loads of people only have one functioning kidney and never even notice. There’s a fair chance you’ve got a knackered one, or maybe even an excess of kidneys. It’s not uncommon.

Because of my many personality failings I barely know any other humans. But even amongst the tiny group of people who can bear me (mainly employees, which surely doesn’t count, because I have to pay them to hang out with me) – even amongst those few people, I know one guy who has 6 kidneys and another with 8. And that’s somewhat lavish, given that I’m living proof than more than one is totally unnecessary. If I was missing two kidneys I’d be worried, but missing one is no worse than losing a middle toe: unsightly, unexpected and requires explanation, but it doesn’t really impact on your life.

The worse thing about not having cancer, though, is having to mix with people who do. It’s not them, it’s me. No, really, it is. They hate me.

I’m taking part in a clinical trial to find out if it’s safe for former cancer patients to take a drug that might (fingers crossed) cure a load of kidney cancers that currently only have a surgical solution. My cancer was one of those – if the surgery had failed there was, at the time, bugger all they could do. I was lucky mine was operable, in spite of being enormous. But this drug offers the hope that surgery might not be necessary, and I’m doing my little part in checking for side-effects. I’ve been doing it for a year, and it’s perfectly safe so far. But it means every 6 weeks I have to go to Christies Cancer hospital for a scan.

And that’s where the trouble starts.

I roll up to Christies at 9am, and they plonk down a vat of putrid liquid that they’ve tried to disguise with chemical that I’m sure is Agent Orange, or possibly Draino. I have to drink 2 small cups of it, and then another cup every 15 minutes for 2 hours. It’s got radium in it, so after the scan is over I’m made to chew a chalky and nasty iodine tablet to soak up the radioactivity, and although it’s (sadly) never happened yet, I’m always warned that the drink might make my poo glow in the dark. I’ll keep you informed about my motions.

Then they make me dress in a humiliatingly arseless hospital gown, shove a canula into my arm, and sit me in a waiting room with 8-10 cancer patients who are waiting for scans too. And we wait, often for 2 hours.

If you’re in a cancer hospital, cancer is the sole topic of conversation. They’re like those old women who start every discussion with the words “I’m 87, you know”. There’s a polite silence when a new person arrives, but within 15 seconds somebody asks “What’s wrong with you, then?”.

They don’t want to know what’s wrong with you really; they just want an excuse to tell everybody what’s wrong with them. They should blog, it’s much less intrusive.

There follows a litany of melanomas, carcinomas, lymphomas and sarcomas. It would scare the bejeesus out of me if I wasn’t aware that 90% of all cancers are now completely curable. This ward is full of the exceptions, but it takes presence of mind to remember that, and not to suddenly freak out that every human on the planet is currently host to a massive tumour

They take it in turns to tell their story, and everyone says the same things:

The NHS is a marvel, Britain’s greatest achievement, and we’ll be lost without it (are you listening Andrew Lansley, you callous cunt?)

Christies cancer hospital, in particular, is a cathedral of care, filled with love and genius, and performing miracles at every moment

Life is a good thing, worth fighting for, and they are determined to live every second

If you’re depressed, go and hang out there. I know I sound like Fight Club, but you’ve never met a bunch of people so determined to have fun. I think that in life we all need something to kick against, and cancer is certainly that. In energises your spirit in some way – I wouldn’t wish it on anybody, not even Thatcher (which is saying something); but it has a remarkable ability to focus your attention on what’s good about life. In case you’re wondering, what’s so good about life is almost everything.

And in most cases, cancer makes you laugh a lot more. Odd, but true. The other patients in the waiting room tell their stories with excellent black humour, giggling at their imminent death or the grisly prospect of a month sat in a chemo chair being carefully, skillfully poisoned to within an inch of their life. They’re brave and honest and clear-eyed and keen to laugh.

But sometimes it stops being funny. Last time there was a guy sitting opposite me, telling his tale. I’d say he was 75 or 80, with male-pattern-baldness and thin, whispy hair lingering above his ears. Sunken eyes, and his hoarse, cracked voice was barely a whisper. He had no teeth, and his skin is like tissue paper. He told us all, with not a hint of self-pity, that he hoped to make it to his next birthday, because it’s an important one.

He’ll be 40.

It’s such a shock to find out that this 80-year-old geezer is actually a couple of years younger than me that I was still slightly speechless when it was my turn to tell everyone what type of cancer is gobbling me up, and I didn’t take enough care to explain things carefully. I just told them truth: there’s nothing wrong with me.

I tried to laugh it off, gave an apologetic shrug and hoped they’d move on. But judging by the looks they gave me, I would have been better to announce that I’d deliberately flambée’d their grandmother and reversed over their dog.

In the normal world, whether you like it or not, you have a disgust of cancer. When somebody tells you they have it, you shrink away from them, avoid them. They remind you that death is at the end of the road, and you don’t want to know that. But I remind these mortally ill people that life is at the other end of the road, and I don’t think they want to know.

They looked at me like I was a fraudster, which is how I feel every time I go to Christies. No matter what’s wrong with you, you can always find somebody worse off in a hospital. But in Christies every single person has a variation of the same thing: their body is turning against them. But not me. I’m fine. I know I’m doing my bit to help them all, but that’s hard to explain. The truth is, I feel like I don’t belong, and am just here to gobble up resources and mock their death with my life.

It affected me in several ways: as a medical emergency, as a psychological shock, and as a variety of minor changes to how I feel, who I am, and what I can do.

Medical stuff

The medical emergency part was fine. I wasn’t unsettled or concerned. There was pain, but there was also pain medication. And I took the view that everything that could be done was being done.

So I wasn’t too worried, because you should only ever worry about things you can change. And within 6 weeks the medical aspect was over.

Physical recovery

In the immediate aftermath, everything was wonderful. The birds in the trees, the kids playing next door, the feeling of rain on my face. Life was grand.

I struggled to move for a few weeks, but then suddenly one day I could do a sit up or two, and before you know it I feel more or less fine. It’s about 10 months since the operation, and my scar-area still feels a little odd. Slightly bruised, and slightly numb too. But physically I’m back to normal.

Side-effects

I’m taking part in the trial of a new drug, which is a smart chemotherapy that targets cells which mutate into the cancer I had. It’s shown a lot of promise in people who have the cancer, and now they want to try it on people who don’t, but who are at risk of it coming back. That’s me. So I take the drugs.

There are side-effects, but not terrible. My hands and feet ache. I sometimes get headaches, but not noticeably more than I used to. One of the side-effects is that the drug makes your skin itch, so to counter this there’s a steroid in it, which makes it difficult to keep weight off. I have to watch the biscuits (which is a problem when you’re addicted to HobNobs).

I found out today that I’m not allowed to go to Kenya. The drug reduces my resistance to yellow fever, and a vaccination would be useless. So I’ve had to cancel a trip that I was looking forward to. It was only business, and only a few days, but I’m disappointed. I’d been dreaming of an African sky.

Psychological stuff

I’m not immortal. I think boys believe they are, and even though I’m 41 now I still retained that sense that life would just bounce off me. That feeling has gone. I don’t tiptoe through life in constant fear, but I’m aware now that shit happens. Injury and sickness are not just abstract ideas now. They feel very real.

And I’m going to die. This is different from simply not being immortal. The immortality thing is a feeling that I have a certain vulnerability. When I say “I’m going to die” I mean that inside me, at the back of my head, there’s a clock ticking. It’s going all the time. It’s reminding me that a year ago I thought for a while that I was on my deathbed, and that a whole army of regrets swarmed up around me.

I don’t want to regret anything. I want to grab hold of life and shake it up. I find myself frustrated and saddened by people who do exactly what I wanted to do a year ago – sit on the sofa after work, and forget about the world.

I’m aware that this makes me a total hypocrite. A couple of years ago I would be happy to get drunk or stoned, and lie around all day watching TV. I still like to lie in bed longer than I should, especially when it’s cold outside. But that’s a definite pleasure in itself, not the refusal to do anything else. As soon as I’m up I want to make the day count.

Oddly, people who know me say I’m much happier and more positive about life since the cancer. I thought I was happy before, but apparently I’m full of beans and smiles and action today. Who would have imagined that illness, vulnerability and intimations of doom would make a person so happy?!

A month since the surgery, and I’m invited back to hospital to get some results.

Girlfriend comes with me, and as we sat outside the surgeon’s office I happened to mention that she might find the surgeon appealing. As much as I could tell, which isn’t very much at all, he seemed like the kind of bloke girls like: he has a booming, confident voice, hair, hands and teeth. There was something hero-doctor about him.

I had no idea. She was positively gooey about him by the time we’d had the results, although part of me wonders if she’d be quite so keen if the results weren’t quite so positive. I found a photo of him when we got home, and made it into her iPhone wallpaper.

For those who care, I had chromophobe renal cell carcinoma (cRCC). He showed me a photo of my kidney. Here it is. The lower image has my drawing of the correct size/shape of a normal kidney.

Dear reader, you’re probably hurling all over your laptop, but I think this photo is seriously cool. How many of us get to see one of our own internal organs on a slab?

The cancer is pretty big, as you can see, but it’s slow-growing and doesn’t appear to have broken out and spread anywhere else.

Kidney cancers don’t respond to chemotherapy or radiotherapy (who knew?), so if the same cancer occurs anywhere else in my body there isn’t much they can do.

But fortunately, cRCC doesn’t spread very easily, and even if it does come back I’m having a series of scans for the next 3 years to spot it early. There’s a 50-50 chance of a recurrence, but if it rears its pug-ugly head again they’ll do a microsurgery to whip it out.

And I’m being put on a trial of a new drug, which is a “smart chemotherapy”. It’s been trialed already on people in end-stage cancer, and now they want to try it on somebody like me: just had the cancer, but it’s been removed with surgery. They want to see if, in lower doses, it can prevent the cancer from returning.

“Here are enough pills to last 3 months”, says the man. I take the pills. “Be careful with those, they cost £6,000 for a month’s supply”.

Gulp.

So I’m on this for 3 years. That’s a total of £216,000 of drugs. Add to that the cost of surgery (let’s say £10,000) and a six-week hospital stay (let’s say £2,500 per week, or £15k) and full body CT scan every 3 months for 3 years (let’s say £3,000 per scan) and you come to a total cost of….

Fucking hell. That’s £350,000.

Fucking hell.

All to keep me alive? Me! Am I worth it? Seriously? Wouldn’t it make more sense to just hand me £100,000 on the understanding that I drink myself to death in a Dutch brothel within a month.

Two days after surgery I had a visit from the specialist urologist and his friend the oncologist.

They have news. It’s exciting, I can tell. It’s written all over their faces. The cancer is the biggest one they’ve ever removed, or at least the biggest kidney cancer. It was 17cm across, and weighed 7kg. That’s bigger than a large supermarket chicken, and the weight of two moderate babies.

Typical men: it’s all about size.

But then they explain that the exciting news is that it was all contained within the kidney – none of it had spread to other organs, which is actual, real life good news. They took out an adrenal gland as well, just to be sure, but it looks like surgery has solved the problem.

I no longer have cancer. Now we just have to wait for the histology reports, so we know what type it was, and what chance there is of it returning.

I have to move

I can’t lie around. If I do, my stomach muscles will start to heal in an odd position, and I’ll be permanently warped. Physically, they mean. I’m already mentally and sexually warped.

So 4 nurses carefully ease me into a sitting position, and then I’m gently hauled to my feet. I’m made to stand as straight as I can and told to walk 20 paces. This is easier said than done, and I have to stop for a rest a couple of times. I’ve done 20 paces and I’m exhausted, and need my next morphine dose. But look: I’m 20 paces away from it, and now I have to work out how to turn around and go back.

No more fun

Morphine gives you incredible dreams. Hearing about other people’s dreams is profoundly dull, like being the only blind person at a 2 hour slide show presentation of somebody else’s holiday snaps. So I’ll spare you the details, and simply tell you that at once stage I was flying over 1945 Berlin, dropping sherbet bonbons, which exploded into clouds of sugar. Bonbons featured in a lot of my dreams, and I haven’t had one, seen one or thought about one for 30 years or more.

But the fun is over. I have to come off the morphine now. It’s only 2 days since the operation, but from now on I’m their bitch. Regular walks, marching up and down the ward. And all that waits for me is a cup of tea and a few mild little cocodamol tablets.

And then

And then I’m sent home. Four days later, and just in time for Doctor Who.

The human body is remarkable. They made a 13 inch cut across my belly, hacked their way through me until they reached the back and cut out a vital organ. Two days ago I could hardly walk. Today I got out of bed on my own, showered, dressed, and did 20 laps of the ward. So I don’t need them any more, and I’m going.

Brother came to collect me (girlfriend doesn’t drive). I carried my own bag down to the hospital reception because I couldn’t wait to see the back of that fucking ward. Don’t get me wrong, the staff are amazing and the service is incredible. It’s only a few weeks since I discovered I had a massive cancer, and only 4 days since surgery, and now I’m cured and on my way to my own bed. But by God and Sonny Jesus, I never want to be here again.

I’ve lost 3 stone in weight, although almost 2 stone of that was left on the surgical bed. But I’m fine, and glad to feel the wind on my face as we walk slowly to the car.

That’s all I remember until I start to come round in the lift heading back up to the ward.

It’s seven hours later. Pain pain pain pain pain pain… and then I realise I’m saying it out loud and make myself stop. Three people stand over me in the lift. I ask them if it went OK, and they bend over me to try to understand what I’m saying, but maybe they can’t, or maybe I can’t remember their reply.

Next thing there are hands all around my face, and I figure out I’m in the corridor outside the ward, and the hands belong to my family. I can’t see mum but I can hear her saying my name over and over. Brother later told me he was angry with her – she’d insisted on staying away until 2 minutes before I went into surgery, when she’d suddenly insisted on being present. He’d wanted to wait for me the whole time, but had to leave to fetch her. Doesn’t matter, I was under for 7 hours, he could have driven to Edinburgh and back.

They all look so worried, so I say, “I’m OK. I’m OK”. And then I realise I have no idea if I am or not, and ask, “Am I OK?”. I don’t think they understand any of this.

Apparently my first cogent words were “The epidural failed”, which banjaxed the whole family. None of them even knew I was pregnant.

Memory of the next bit comes and goes, but I remember being told how to use the morphine drip. Here’s the button. If it hurts, press it and you’ll be given a dose.

I press it and nod out. When I come back they’re explaining again and asking me to not press it until they’ve finished explaining: I can press it once every 3 minutes. I press it because it hurts, and nothing happens. I have to wait until the light comes on. This is the longest 3 minutes since Ali vs Frazier.

Counting to 180 is too difficult in my current state of mind, so I just press it and press it until I nod out.

I’m awake more fully in the night, or perhaps early morning. The anesthetic fug has worn off, and I can tell what’s happening a little more, but only when the morphine is overwhelmed by the pain and I’m dragged into an urgent awareness of what I need to do: press the button. I can’t move very much. Even lifting my head off the pillow is very painful in my belly, and I struggle to look down at my wound. A pipe leads out of my lower abdomen, and I don’t know why. Nobody had mentioned this before.

A nurse comes in and I hand her my phone and ask her to take a photo, partly for a record and partly so I can see what’s been done. I had asked if someone could take a photo of the surgery, but it’s not allowed. This is the next best thing.

When I see the photo I’m appalled. Am I that fat? But no, it’s swelling. It’ll go down.

The wound is as big as I’d expected. It’s 1/3 of the way around my body. It’s cut through the major muscle groups in my stomach, which means I can’t lift my legs or head, turn my body, or bend in any way. When I get a dose of morphine and nod out, I almost always drop button and it falls on the floor. When I come round I panic and yell for someone to hand it to me. After a few times they tie it to my wrist.

I have visitors. Everyone. I think I’m doing OK and chatting with them, but afterward they tell me that I was caned off my tits, and just stared at the morphine button waiting for the light to come on. When it did I’d press it, nod out for 2 minutes, and then the pain would wake me up in time to press it again. If they were lucky, they could get me to say a couple of words in that few brief moments between consciousness and the next dose of morphine.

It turns out the pipe coming out of me is a precaution. Kidney surgery either doesn’t bleed at all, or bleeds in pints. The pipe lets them syphon off blood.

My surgery was planned for 17th, but after the TWOC fiasco they decided to bring it forward.

So surgery actually happened on the 6th. The night before I wrote some notes on my broken phone, just in case things came out badly. Just a few little messages for my mum and girlfriend, and a final invitation for my brother to fuck off.

I’ve deleted them now. They were very sentimental, which isn’t like me at all.

The show started at 1pm, so in the morning I watched everyone else eat Weetabix, and then had a nap on the bed. If I was worried, it wasn’t preventing me from sleeping.

Am I a sociopath?

Brother arrived at 12:00 and told me he’d wave me off for the operation, and welcome me back afterwards. He must be concerned, he’s never been nice to me before. Mum isn’t coming because “she doesn’t want to get in the way”. We laugh about this. Typical: she worries about everything, and now she thinks that her presence in the hospital will somehow put off the surgeons? She’s an absolute nervous mess.

I read for a bit, and then the porters came in and wheeled me down. En route I was overtaken by my surgeon. He’s so confidently blasé about it all, the polar opposite of my hilariously terrible GP. An operation this big probably happens to 1 in 10,000 people, and is an incredibly big deal for me. But for him it’s every day. Probably twice a day. It’s a job.

Prep was unexpected, but then I don’t know if I’ve ever thought about it before. It’s a small ward of perhaps 20 beds, with a constant turn-over. I was there for maybe 35 minutes, and in that time the entire population of the ward changed twice. It’s a production line. We’re not patients down here, we’re a bunch of malfunctioning machines.

I’m asked the same questions 5 times, once every 5 minutes. I guess they have to be very certain they’re doing the right thing to the right person:

What’s your name?

What’s your date of birth?

What’s wrong with you?

What surgery are you having today?

I like saying “right radical nephrectomy” rather than “right kidney removed”. It gives me that same sense of belonging that you get when you manage to use a few words of French in Paris.

The anesthesiologist told me they’re going to give me an epidural so I can cope with the pain after the surgery. Odd: I hadn’t even thought about pain after surgery. I’m glad he has! So I’m wheeled in to pre-op and made to sit on the side of the bed. An assistant sticks a huge plastic sheet to my back and makes a small hole in it. I’m asked to arch my back as much as I can, so my chin is pressed on my chest.

I try, but I’m a rugby boy. Thick set, sturdy, inflexible. I can’t bend enough to make a gap between the vertebrae, and he keeps trying and trying. He’s put the needle in 4 times, and still can’t get into the epidural canal. I can feel him getting frustrated behind me.

The assistant holds me by the neck and pushes my head down as far as he can, but this just isn’t happening. So they give up and tell me they’ll work out a different pain regime for me while I’m under. They tear off the plastic sheet, and I feel like I’m being waxed.

I lie down. A drip or two go in, and a bunch of cardio sensors on my ankles, chest and neck. I’m perfectly calm, I notice. Am I a sociopath?

The anesthesiologist gives me a cord to hold with a button at the end. He tells me not to press it, and suddenly I’m reminded of Dougal in Father Ted, being invited into the cockpit and seeing a big red button marked “Do Not Press”. They’re bustling around above me.